Published Jan 1, 2018
karenbee8
7 Posts
I have an assignment and i figured that you need to check whether the tube hasn't moved anywhere. Another is if the tape is secured. But i'm struggling to work out another check
Agatha12
75 Posts
Checking pH and X-ray
RJ 55
15 Posts
Hi!
Whenever I have a patient that has an existing NG or OG in the Emergency department (usually from a transfer) I will check placement of the tube. Or if I am receiving report from another nurse and I am concerned that it may not be placed correctly or if my patient had a change in position. I first check by auscultation. Also, when you pull back on the syringe you should see gastric content. You can pH test the content if your facility has the testing strips. You can also verify placement by XR or CT (usually patients that need a NG or OG will have further diagnostics ordered). I once had a patient who was a trauma transfer. I auscultated to confirm OG placement (he was intubated with poor oxygen saturation). XR tech swooped in on our trauma code and the XR showed the OG tube was in the lung. Once we pulled it out he began ventilating and perfusing much better. Hope that helps!
amoLucia
7,736 Posts
A secured taping does NOT insure that a tube is properly in place. A tube could be coiled and as PP RJ55 comments could be straight in the lung!
Banana nut, BSN, RN, EMT-B
316 Posts
You should also check residual per md order, patency of the tube, if the order is to be hooked up to suction, is the suction at the right level? and is it intermittent or low continuous. and if it's a salem sump and it's hooked up to low continuous you need to make sure the blue air vent is not blocked off.
Guest123456788, MSN, RN
146 Posts
The three main checks we have always learned is check the measurement (e.g. make sure the tape is at the length on the tube it is supposed to be to check if the tube has either slid out or moved farther in), check the pH of the tube contents, and Chest x-ray which is the gold standard for checking placement. I believe many facilities do still auscultate but it has been shown to be ineffective so we aren't being taught that in school anymore.
NICUmiiki, DNP, NP
1,775 Posts
Auscultating an NG tube is NOT evidence-based practice, so don't pick that one. IRL, you will see people still do it.
chare
4,326 Posts
Initial and Ongoing Verification of Feeding Tube Placement in Adults (applies to blind insertions and placements with an electromagnetic
device)
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.627.3203&rep=rep1&type=pdf
http://emjreviews.com/wp-content/uploads/Risks-of-Using-Bedside-Tests-to-Verify-Nasogastric-Tube-Position-in-Adult-Patients.pdf
Ambersmom, BSN, RN
189 Posts
answered by someone else
Initial and Ongoing Verification of Feeding Tube Placement in Adults (applies to blind insertions and placements with an electromagnetic device)http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.627.3203&rep=rep1&type=pdfhttp://emjreviews.com/wp-content/uploads/Risks-of-Using-Bedside-Tests-to-Verify-Nasogastric-Tube-Position-in-Adult-Patients.pdf
This is fantastic! Thank you for the link.
NICU Guy, BSN, RN
4,161 Posts
Wasn't this question answered in your previous thread?
https://allnurses.com/general-nursing-student/what-3-routine-1143922.html
Some details re what you've determined to be important?
OP did ask in another post re NASO tube. And also about interventions for an insulin drip.
Multiple homework questions.